Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.77 / $23.61 / $67.47	Facility	26	$12.77	$23.61	$67.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $41.93 / $210.00	Professional		$36.88	$41.93	$210.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $12.98 / $29.23	Professional	26	$11.50	$12.98	$29.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $28.75 / $59.09	Professional	TC	$25.37	$28.75	$59.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $41.07 / $42.26	Facility	26	$39.86	$41.07	$42.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $101.62 / $127.02	Professional		$44.15	$101.62	$127.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $31.03 / $40.19	Professional	26	$14.36	$31.03	$40.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.64 / $70.59 / $88.24	Professional	TC	$29.64	$70.59	$88.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $63.76 / $118.04	Professional		$38.34	$63.76	$118.04
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $19.96 / $41.52	Professional	26	$12.80	$19.96	$41.52
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $40.64 / $73.34	Professional	TC	$25.54	$40.64	$73.34
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $41.07 / $100.00 / $100.00	Facility	26	$41.07	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $68.98 / $282.23	Professional		$40.22	$68.98	$282.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $18.95 / $100.72	Professional	26	$14.34	$18.95	$100.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $34.21 / $254.00	Professional	TC	$25.68	$34.21	$254.00
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $41.07 / $42.26 / $77.40	Facility	26	$41.07	$42.26	$77.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $86.08 / $148.30	Professional		$72.20	$86.08	$148.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.68 / $39.21 / $71.90	Professional		$13.68	$39.21	$71.90
United Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $50.29 / $82.54	Professional		$40.22	$50.29	$82.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $17.46 / $29.63	Professional	26	$14.34	$17.46	$29.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $33.38 / $52.32	Professional	TC	$25.68	$33.38	$52.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.09 / $74.80 / $88.00	Professional		$59.09	$74.80	$88.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $23.40 / $27.50	Professional	26	$18.48	$23.40	$27.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $40.61 / $51.40 / $60.50	Professional	TC	$40.61	$51.40	$60.50